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Case Report: Hypercalcemia and Acute Kidney Injury Associated with Disseminated Paracoccidioidomycosis
Renan Gomes Mendes Diniz
renangomesdiniz@gmail.com
Renan Gomes Mendes Diniz
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Betina Nogueira Da Silva
Betina Nogueira Da Silva
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Raoni De Oliveira Domingues-Da-Silva
Raoni De Oliveira Domingues-Da-Silva
Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil
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Marcelo Arnone
Marcelo Arnone
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Walter Belda Júnior
Walter Belda Júnior
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Elizabeth De Francesco Daher
Elizabeth De Francesco Daher
Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil
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Lucia Andrade
Lucia Andrade
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
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Paracoccidioidomycosis is an acute to chronic systemic mycosis caused by the fungi Paracoccidioides. Hypercalcemia is a rare and not fully understood presentation of this infection. We present a case report of paracoccidioidomycosis associated with hypercalcemia and acute kidney injury (AKI) in an immunocompetent patient. An immunocompetent 30-year-old man from Brazil presented with papular erythematous-violaceous skin lesions, disseminated lymphadenopathy, pain in the left hypochondrium, fever with night sweats, and loss of 25 kilograms in 5 months. The result of a biopsy of the lesions was positive for Paracoccidioides brasiliensis. Laboratory findings were high total calcium and 1,25-dihydroxy vitamin D, with low parathyroid hormone, low albumin, and AKI. Computed tomography scans revealed splenic infarcts without bone lesions. Treatment was performed with methylprednisolone and liposomal amphotericin B. Calcium levels and kidney function normalized within 20 days of hospitalization. The patient was discharged 49 days after admission. A follow-up 6 months later revealed total clinical and serological remission.
Author Notes
Current contact information: Renan Gomes Mendes Diniz and Lucia Andrade, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, E-mails: renangomesdiniz@gmail.com or drdiniznefrologisa@gmail.com and luciacan@usp.br. Betina Nogueira Da Silva, Marcelo Arnone, and Walter Belda Júnior, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, E-mails: betina_nogueira@hotmail.com, arnones@uol.com.br, and walterbelda26@gmail.com. Raoni De Oliveira Domingues-Da-Silva and Elizabeth De Francesco Daher, Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Brazil, E-mails: domingues.raoni@gmail.com and ef.daher@uol.com.br.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 398 | 398 | 222 |
| Full Text Views | 9 | 9 | 8 |
| PDF Downloads | 14 | 14 | 12 |